Lymphedema Therapy

What is lymphedema and how does the lymphatic system work?

Lymphedema is an abnormal buildup of lymphatic fluid in the arms, legs or other parts of the body, resulting in chronic, progressive swelling.

Under normal conditions, the lymphatic system collects extra fluid in the body and filters it before flowing back to the heart or being eliminated through the kidneys. In lymphedema, the fluid is unable to drain from a body area because the lymphatic system is impaired or damaged due to heredity, surgery, venous insufficiency, traumatic injury or cancer treatment.

How do I recognize lymphedema?

Primary lymphedema, a genetic condition, can be present at birth or develop during puberty or in adulthood. Secondary, or acquired, lymphedema can develop as a result of cancer surgery, orthopedic or general surgery, radiation treatment, venous insufficiency, chronic obesity, medication side-effects, or trauma. When lymph nodes are removed, there is always a risk of developing lymphedema. The start of symptoms can also be due to multiple health factors that deteriorate the system’s ability to function over time. Lymphedema can develop immediately or be diagnosed weeks, months and even years after the system has been impaired. If you suspect any of the symptoms listed below, discuss treatment potential with your doctor. Early diagnosis and appropriate treatment improve both the current condition and your future health.

Symptoms may include:

• Visible persistent swelling or puffiness, perhaps noted particularly around bony areas
• A full, heavy, or achy sensation in a specific area of the body
• Skin tightness, firmness, or pain
• Decreased flexibility in specific joints
• Difficulty fitting into clothing in one specific area
• Tight-fitting shoe, sock, bracelet, watch, or ring that was not tight before

Who can help if I have swelling?

Lymphedema Therapy is a program offered through CSSMCW’s Occupational Therapy Department. An occupational therapist with advanced training and certification in lymphedema establishes a plan of care using the methods of Complex Lymphatic Therapy (CLT). Goals of treatment include improvements in swelling, pain, skin abnormalities, mobility and daily function/activity.

All patients must be referred for therapy by a physician. Prior medical treatment by a physician is recommended if you are newly diagnosed with one of the following conditions: Deep vein thrombosis (DVT/blood clot), congestive heart failure (CHF), kidney failure, infection and active cancer.

What is the treatment for lymphedema?

The following components may be used in the treatment of lymphedema:

• Manual lymphatic drainage – a massage that detours fluid to healthy, functioning areas
• Compression bandaging – an increased pressure on the limb to reduce the size of the affected area
• Education in skin care
• Low-level laser therapy – performed to reduce pain and swelling and increase scar mobilization
• Decongestive exercises and breath work – yoga postures and traditional exercises to enhance fluid pumping effects of joints and muscles; breathing techniques to stimulate the lymphatic system and enhance overall wellness
• Compression garments – fitting for effective size/pressure and training in home use of compression wear to prevent fluid re-accumulation in the limb
• Home program – Patient/care giver instruction for lymphatic massage, bandaging, garment use, and self-monitoring of symptoms.
• Pneumatic Compression Pump – appropriate patients may be referred to obtain a compression device that mechanically assists in stimulating fluid movement as a tool for the home program.